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Hello

Hola

- Getting Better Together Everyday -

FILL OUT OUR FAST & EASY APPLICATION
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- ABOUT US -

We are a group of passionate individuals in recovery including indigenous men and women. Our mission is helping our Native relatives to recover.

This program is for both men and women who are tribal members and are willing to make a commitment to completing the treatment program.

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- MEET OUR TEAM -

- OUR FRIENDS & RESOURCES -

HEALING THE CIRCLE
WELLBRIETY
SAMHSA
 

- APPLICATION -

Please make sure your personal info is correct or it may delay the process. Please use your full legal name as it is on your birth certificate ID or CDIB card.

Gender
Marital Status
Are you a member of a Federally recognized Tribe?
Upload File
Upload File
Are you currently abusing any substances?
What substances are you currently abusing?
Have you ever overdosed?
Are you taking any prescription medications including psychiatric medications?
Has your substance use interfered or caused issues in your personal relationships?
Are you currently dealing with any court issue, misdemeanor, felony, or probation?
If yes, do you have permission from the court or your probation officer to receive treatment out of state?
Do you have any family or friends who support your recovery?
Are you in any immediate danger to yourself or others?
Are you currently living in a safe place?
Within the past two years have you tried to seriously harm yourself or attempt suicide?

Thank you for submitting! We'll be contacting you soon.

 

- MEET OUR TEAM -

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CAREY RAFFERTY

CEO

(714) 679-9175

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SPARROW GOUDY

PROGRAM MANAGER

(760) 803-1165

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- Transitions Wellness/Wellbriety Graduates -

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- BACK TO APPLICATION -